NPIMap

Organization Active NPI

Camelot of Staten Island, Inc.

Doing business as Camelot Counseling Centers

  • Addiction (Substance Use Disorder) Counselor
  • Staten Island, NY
National Provider Identifier
1942359476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
CAMELOT OF STATEN ISLAND, INC.
Doing business as
Camelot Counseling Centers
Practice address
263 Port Richmond Avenue
Staten Island, NY 10302
Phone
(718) 981-8117
Fax
(718) 981-8309
NPI assigned
Jan 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Luke J. Nasta, MPA, CASAC
Title
Executive Director
Phone
(718) 356-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

263 Port Richmond Avenue
Staten Island, NY 10302

Mailing address

4442 Arthur Kill Rd Ste 4
Staten Island, NY 10309-1321
Phone (718) 356-5100

Other identifiers 1

IdentifierTypeStateIssuer
01292768MedicaidNY

Other names 1

  • Camelot Counseling Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Camelot Counseling4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

946 E 211th St
Bronx, NY 10469
Phone (718) 323-3275

1268 Forest Ave
Staten Island, NY 10302
Phone (718) 356-5100

263 Port Richmond Ave
Staten Island, NY 10302
Phone (718) 981-8117

273 Heberton Ave
Staten Island, NY 10302
Phone (718) 412-3170

4442 Arthur Kill Rd
Ste 4
Staten Island, NY 10309
Phone (646) 508-7565

460 Brielle Ave
#H
Staten Island, NY 10314
Phone (718) 427-4385

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942359476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4442 ARTHUR KILL RD STE 4",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091321",
            "telephone_number": "718-356-5100",
            "fax_number": "718-981-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 PORT RICHMOND AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10302",
            "telephone_number": "718-981-8117",
            "fax_number": "718-981-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT OF STATEN ISLAND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NASTA",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-356-5100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA, CASAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01292768",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Counseling Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.